BB Flashcards
What is the weakest adductor that is often transplanted?
Gracilis M.
What can hamstring tears damage?
Ischial tuberosity.
What happens during a hamstring tear?
Muscle fibers can contuse and bruise and then you can damage the artery supply to these muscles.
Common in athletes who do not tear.
In hamstring tears, how is the ischial tuberosity torn?
Forced flexion of the hip with your knee extended.
Ex. Kicking a soccerball
What does the popliteus m do?
Unlocks your knee by laterally rotating the femur when your tibia is stationary
Actions of the true hamstring muscles
- Extend thigh
2. Flex leg
Order of components of popliteal fossa
From superficial to deep
- Sciatic nerve
- Popliteal vein
- Popliteal Artery
NVA
What happens if we get an absess in our popliteal fossa?
Deep popliteal fascia is strong and does not like to expand.
An absess here is bad; spreads superiorly–> inferiorly.
Where can we find the popliteal pulse?
Hard to find.
Person must lay prone with their knee flexed to relax the fascia. The pulse will be at the inferior part of the fossa
If the popliteal pulse is weak, what can this indicate?
Femoral artery obstruction
What can happen because of a popliteal aneurism?
It can stretch the nerve or compress the blood supply because the artery is DEEP to the tibial n.
Pain from the compression will be referred to the skin on the [calf, ankle, foot]
Pain on the calf, ankle or foot can be due to what?
Referred pain from the popliteal nerve.
FX of the DISTAL femur or dislocations of the knee will damage the
POPLITEAL ARTERY
Damage to tibial nerve
paralysis of flexor muscles in leg and muscles on the sole of the foot;
Thus, cannot plantarflex or flex toes!
Loss of sensation on toes
Describe the mechanisms that permit venous return of blood from the leg, as well as the consequences of failure in these mechanisms.
The Crural Fascia forces contraction of muscles inwards, rather than outward. This acts as a pump for the veins of the leg. In elderly populations, where the Crural Fascia is less dense, one can see edema in the lower legs.
Inability to plantar flex is due to
damage to tibial n
What causes the pain and edema in the distal 2/3 of the tibia in shin splints?
This is due to microtrauma of the TIBIALIS ANTERIOR M.
Causes small tears in the periosteum that cover the tibia.
Shin splints are a mild form of what?
Anterior compartment syndrome
When do shin splints commonly occur
Overexertion of muscles in anterior compartment by people who are untrained or sedentary or trained who do not warm up right.
Muscles in the anterior compartment will swell from sudden oversue and reduce flow.
Containment and Spread of Infection in the Leg
The fascia compartments in the lower limb are closed spaced that end at the proximal and distal ends of joints.
Becaise the fascia of the leg is thick and strong, the formation of pus will create intracompartmental pressure.
Inflammations in the anterior and posterior compartments of the legs spread in what direction?
DISTAL direction
Inflammations in the LATERAL compartments of the legs spread in what direction?
ASCEND proximally into the into the popliteal fossa.
Most often injured nerve in lower limb?
Common fibular nerve bc is wraps around the fibular neck
What nerve is severed during fx of the fibular neck or severely stretched when the knee joint is injured or dislocated
common fibular n
Severence of common fib n results in what
flaccid paralysis of ALL muscles in anterior, lateral comparments
- Cannot dorsiflex or evert the foot
- Foot drop
In damage to common fib n, will the limb be too long or too short?
too long
how can we compensate for limbs that are too long
- waddling gate- person leans to side opposite of long limb
- swing-out gait- limb is swung out (abducted)
- High stepping steppage gaite (most common)
What supports the TALUs and has the groove for flexor hallucis longus?
Sustentaculum tali
What muscles are the most uselful to help maintain our arch?
- Tibialis posterior m.
2. Flexor hallucis longus m.
What ligament is an important passive support for the medial site of the foot?
Spring ligament
Plantar calcaneonavicular l
Where does the flexor digitorum longus sit?
tibial side, away from the toes it flexes
Where does the flexor hallucis longus sit?
fibular side, away from the toe it flexes
What muscle do you see the most of in the posterior leg
flexor hallucis longus
Why is the tendon of tibialis posterior good arch support
it creates a sling that holds up the arches of the foot.
Which muscles oppose the eversion action of the fibularis muscles?
Tibialis anterior and tibialis posterior
How do we rupture calcaneal tendon?
Snap during forceful push off (plantarflexion with the knee extended).
What muscles are affected in ruptured calcaneal tendon
gastroc
plantaris m
soleus m
Effects of a ruptured calcaneal tendon
cannot plantarflex and too musch dorsiflextion
How do pppl with Ruptured calcaneal tendon walk
leg rotates laterally
How do we gastrocnemius string
overstretching by
- extension
- dorsiflexion
Venous return to the leg depends on
muscular ability of the tripceps surae
Biogenic amines
DA, SA, EPI, NE
Neuropeptides
ACTH, glucagon and endorphins
Amino Acids
glutamate, glycine and GABA
Duchenne limp is due to damage to what n
superior gluteal nerve
where should buut injections be made
between PSIS and Superior border of greater trochanter of femur;
within margins of glut medius.
Trochanteric bursistis is due to
repetitive actions like climbing stairs while carrying heavy things or running a treadmell
WHat causes trochanteric bursitis
fibers of the glut max moving over fibers of bursa on greater trochanter.
effects of trochanteric bursitis
pain in lateral thigh
Pain is eliciited by resiting [abduction and lateral rotation]
What is ischial bursisits
caused by activites that involve hip extension on; cycling rowing.
Ischial bursa is overwhelmed and cannot stop stress. Pain increases with movement of glut max.
These bursa bear weight of someone sitting so can lead to sores in debilated people.
People with superior gluteal injury cannot do what actions
abduct
medially rotates
Piriformis syndrome
sciatic n is compressed by the piriformis muscle
Hypertophy of butt and spasm
Damage to sciatic n
leg is useless
Damaging what side of the butt is worse: medial or lateral?
MEDIAL! Can injure sciatic n and hamstrings
